Ref No.

AUSTRALIAN GOVERNMENT

DEPARTMENT OF HEALTH

HEALTH INSURANCE ACT 1973

Health Insurance (Medicare Benefit Payable in Respect of Professional Services—Murrumbidgee Local Health District) Direction 2020

I, Paul McBride, First Assistant Secretary, Medical Benefits Division, Health Resourcing Group, delegate for the Minister for Health, acting under subsection 19(2) of the Health Insurance Act 1973, hereby:

DIRECT that Medicare Benefits shall be payable in respect of:

(a) A professional service (as defined in Section 3 of the Health Insurance Act 1973) which has been agreed to be provided under the Memorandum of Understanding (MOU) between the Department of Health (ABN: 24 004 196 909) and the Murrumbidgee Local Health District (ABN: 71 172 428 618) (MLHD) in relation to the rural generalists innovative employment model trial within the Murrumbidgee region for which;

(i) items specified in Schedule A of this Direction; and

of the general medical services table (means the table prescribed under subsection 4(1) of the Health Insurance Act 1973), diagnostic imaging services table (means the table prescribed under subsection 4AA(1) of the Health Insurance Act 1973) and pathology services table (means the table prescribed under subsection 4A(1) of the Health Insurance Act 1973) relates: and

(b) Where the professional service is provided to:

(i) an eligible person (as defined in Section 3 of the Health Insurance Act 1973); and

(ii) a patient who is not receiving an episode of hospital treatment (as defined in Section 121-5 of the Private Health Insurance Act 2007); and

(i) is professional attendance provided in a general practice (as defined in Section 7.1.1 of the general medical services table); and

(ii) is provided at an approved Modified Monash Model 4-7 (as defined in Section 7.1.1 of the general medical services table) practice location specified in Schedule B; and

(iii) is provided by a participating rural generalist trainee (as defined in the MOU mentioned in (a)):

who is centrally employed, with a salary, by the MLHD for the provision of primary and acute care services: and
is registered in the rural generalists innovative employment model trial within the Murrumbidgee region.

DECLARED that this Direction shall have effect from the date of signature until
31 December 2024 inclusive unless earlier revoked.

Date this 19th day of October 2020

Paul McBride

First Assistant Secretary

Medical Benefits Division

Health Resourcing Group

Department of Health

SCHEDULE A

MEDICARE BENEFITS SCHEDULE ITEMS AS AGREED IN THE MEMORANDUM OF UNDERSTANDING BETWEEN THE DEPARTMENT OF HEALTH AND THE MURRUMBIDGEE LOCAL HEALTH DISTRICT

For services listed in the below tables, all provisions of the Health Insurance Act 1973 (the Act) and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items apply.

General Medical Services Table

Group	Group Name	Subgroup	Subgroup Name
A1	General practitioner attendances to which no other item applies
A2	Other non-referred attendances to which no other item applies
A5	Prolonged attendances to which no other item applies
A6	Group therapy
A7	Acupuncture and non-specialist practitioner items	All
A11	Urgent attendances after-hours
A14	Health assessments
A15	GP Management plans, team care arrangements and multidisciplinary care plans and case	1	GP Management plans, team care arrangements and multidisciplinary care plans
A15		2	Case conferences
A17	Domiciliary and residential medication management reviews
A18	Attendances associated with Practice Incentive Program payments	All
A19	Attendances associated with Practice Incentive Program payments	All
A20	Mental health Care	All
A22	General practitioner after-hours attendances to which no other item applies
A23	Other non-referred after-hour attendances to which no other item applies
A27	Pregnancy support counselling
A29	Early intervention services for children with autism, pervasive development disorder or disability
A30	Medical practitioner video conferencing consultation	1	Video conferencing consultation attendance at consulting rooms, home visit of other institution
		2	Video conferencing consultation attendance at a residential aged care facility
		3	Mental health and well-being video conferencing consultation
		5	General practitioner video conferencing consultation attendance for patients in rural and remote areas
		6	Other non-referred video conferencing consultation attendance for patients in rural and remote areas
		7	Non-specialist practitioner video conferencing consultation for patients in rural and remote areas
A35	Non-referred attendance at a residential aged care facility
A36	Eating Disorder Services	1	GP and Medical Practitioner eating disorder treatment and management plans
		3	Review of eating disorder treatment and management plan
		4	GP and medical practitioner eating disorder s psychological treatment services
A39	Bushfire Recovery Access Initiative – GP and Medical Practitioner Focussed Psychological Strategies
A40	COVID-19 Services	1	COVID-19 general practice - telehealth services
		2	COVID-19 general practice - phone services
		3	COVID-19 Focussed psychological strategies - telehealth services
		10	COVID-19 Focussed psychological strategies - phone services
		11	Health assessments for Aboriginal and Torres Strait Islander People - telehealth services
		12	Health assessments for Aboriginal and Torres Strait Islander People - phone Services
		13	GP management plans, team care arrangements and multidisciplinary care plans via telehealth attendance
		14	GP management plans, team care arrangements and multidisciplinary care plans via phone attendance
		15	GP pregnancy support counselling - telehealth services
		16	GP pregnancy support counselling - phone services
		17	GP, Specialist and Consultant Physician autism service - telehealth services
		18	GP, Specialist and Consultant Physician autism service - phone services
		19	GP mental health treatment plan - telehealth services
		20	GP mental health treatment plan - phone services
		21	GP Eating Disorder Treatment and Management Plan – telehealth services
		22	GP Eating Disorder Treatment and Management Plans - phone services
		25	Review of an eating disorder Plan - telehealth services
		26	Review of an Eating Disorder Plan – phone services
		27	GP - Eating Disorder Focussed Psychological Strategies – telehealth services
		28	GP - Eating Disorder Focussed Psychological Strategies – phone services
		29	GP and Other Medical Practitioner - urgent after hours service in unsociable hours - telehealth services
		30	GP and Other Medical Practitioner - urgent after hours service in unsociable hours - phone services
M1	Management of bulk billed services
M12	Services provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner	1	Video conferencing consultation support service provided by a practice nurse, an Aboriginal health worker or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner
		2	Video conferencing consultation support service provided at a residential aged care facility on behalf of a medical practitioner
		3	Services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner
D1	Miscellaneous diagnostic procedures and investigations	2	Ophthalmology
		3	Otolaryngology
		4	Respiratory
		5	Vascular
		6	Cardiovascular
		8	Genito-urinary physiological investigations
		9	Allergy testing
		10	Other diagnostic procedures and investigations
D2	Nuclear Medicine (non-imaging)
T1	Miscellaneous therapeutic procedures	2	Dialysis
		4	Paediatric and neonatal
		5	Cardiovascular
		8	Haematology
		9	Procedures associated with intensive care and cardiopulmonary support
		11	Chemotherapeutic procedures
		13	Miscellaneous therapeutic procedures
T2	Radiation oncology	1	Superficial
T3	Therapeutic nuclear medicine
T4	Obstetrics
T6	Examination by anaesthetist
T7	Regional or field nerve blocks
T8	Surgical Operations	1	General
		2	Colorectal
		3	Vascular
		4	Ear, nose and throat
		5	Urological
		6	Cardio-thoracic
		7	Neurosurgical
		8	Ear, nose and throat
		9	Ophthalmology
		11	Paediatric
		12	Amputations
		13	Plastic and reconstructive surgery
		14	Hand surgery
		15	Orthopaedic
T9	Assistance at operations
T10	Anaesthesia performed in connect with certain services (relative value guide)	All

Diagnostic Imaging Services Table

Group	Group Name	Subgroup	Subgroup Name
I1	Ultrasound	6	Musculoskeletal ultrasound
I3	Diagnostic Radiology	1	Radiographic examination of extremities
		2	Radiographic examination of shoulder or pelvis
		3	Radiographic examination of head
		4	Radiographic examination of spine
		5	Cardiovascular
		6	Radiographic examination of thoracic region
		7	Radiographic examination of urinary tract
		8	Radiographic examination of alimentary tract and biliary system
		12	Radiographic examination with opaque or contrast media
I6	Management of bulk billed Services

Pathology Services Table

Group	Group Name
P1	Haematology
P2	Chemical
P9	Simple Basic Pathology Tests
P12	Management of bulk billed services

SCHEDULE B

Approved Modified Monash 4-7 Practice Locations AS AGREED IN THE MEMORANDUM OF UNDERSTANDING BETWEEN THE DEPARTMENT OF HEALTH AND THE MURRUMBIDGEE LOCAL HEALTH DISTRICT

Approved primary care Modified Monash Model (MMM) 4 locations:

MMM 4 location	Practice Name	Street Address	Mailing Address
Young	Young District Medical Centre	16 Cloete Street Young NSW 2594	16 Cloete Street Young NSW 2594
Cootamundra	Cootamundra Medical Centre	44 Cooper Street Cootamundra NSW 2590	44 Cooper Street Cootamundra NSW 2590
Deniliquin	Deniliquin Clinic	409 George Street Deniliquin NSW 2710	409 George Street Deniliquin NSW 2710

Approved primary care Modified Monash Model (MMM) 5 locations:

MMM 5 location	Practice Name	Street Address	Mailing Address
Gundagai	Gundagai Medical Centre	95 Sheridan Street Gundagai NSW 2722	95 Sheridan Street Gundagai NSW 2722
Temora	Temora Medical Centre	296-298 Hoskins Street Temora NSW 2666	296-298 Hoskins Street Temora NSW 2666
Narrandera	Narrandera Medical Centre	Victoria Square Narrandera NSW 2700	Victoria Square Narrandera NSW 2700

Note: The name of this instrument was amended on registration as the instrument as lodged did not have a unique name (see subsection 10(2), Legislation Rule 2016).